I will admit, this week sucked. I went into chemo like I do most things, overly confident and headstrong. I thought to myself, “I am young and strong. Chemo is going to be a breeze”. I spent the day getting the IV, went home and felt great. I am fairly certain that my mind helped coast me through a 2-day feeling of utter invincibility. I returned home after hosting Tuesday Trivia (yes, I still work a trivia night) completely exhausted, which is normal since I am working 9am-11pm. As I got ready for bed, I started to feel some stomach pains. Those stomach pains turned into a 2-day hell where I felt as if I was being continually stabbed in the stomach. The only times I felt relief was when I was in a bathtub full of hot water, which seemed to calm my body down. Sadly, I could not stay in the tub forever due to obvious reasons as well as my dislike of pruney fingers. I did try to power through work on Wednesday, though I am fairly certain I was completely useless and a mess. Thursday I was forced to take off because I had not slept in 2 days and could not function. When Thursday afternoon arrived, the pain had subsided and all that was left was a beaten man whose confidence in his chemo ass-kicking abilities was completely destroyed. Thursday came to a close and I felt somewhat normal and able to handle basic tasks, but I still felt anxious. When a person has cancer, chemo is not the only thing that messes with a person’s body. In fact, EVERYTHING a person has to do regarding cancer, whether it be tests, procedures, or treatment all blow and make a person's life as difficult and annoying as possible.

Friday was the day of my liver biopsy. I will leave Clover to write below exactly the purpose of the biopsy and what was done, however the goal was to take a piece of my liver to make sure that we are dealing with the same cancer and to run tests on the cancer to help better fight it in the future. I was placed in an MRI machine which the doctor would use to create imaging to assist him in getting the samples with his magical needle that would be jammed into my body and somehow suck/cut a piece of my liver out. The procedure appears as if it was painless, as there is nothing but a needle mark covered with a band-aid, but an overall feeling of weakness lasted the whole weekend. It is now Monday, and I will go in for round two of my Chemo IV and hope for a better week.

Clover's POV: Liver Biopsy

From what I can tell, the liver biopsy was done for two purposes. First to look at the histology of the tissue specimen to confirm that the lesions metastasized from the primary cancer rather than being a primary liver cancer in and of itself. Although it is likely metastastic based on the nature and number of lesions as well as PET scan results, technically, the only way to confirm this diagnosis is by biopsy. The second purpose was to perform gene mutation testing on the tissue. This is also being done on the primary tumor specimen, however the oncologist wanted the liver tissue examined as well, particularly since the first specimen was quite small.

The liver biopsy itself is done with CT or ultrasound guidance in order to locate the mass as well as visualize the liver anatomy, surrounding structures (to avoid poking the gallbladder, lungs, etc.), and ensure the correct location of the needle. In Ryan's case, it was done with CT guidance. Based on Ryan's description to me, it sounded as though they used suction needles and spring-loaded needles (which work pretty much exactly how they sound) to pluck out liver tissue. From there the tissue is fixed in formalin and various stains and such are applied, and maybe in a week or two we will receive the results.

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This is a personal weblog. The opinions expressed by the authors and contributors of this blog represent their own personal opinions and not those of their respective employers. Additionally, though medical topics may be covered in this blog, they are the personal opinions and thoughts of the authors based on their personal experiences. While care is taken to provide readers with educated information and analyses, they should not be taken as expert or official medical opinion. Thank you.